Predictors of diabetic control among patients with type 2 diabetes mellitus

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Predictors of diabetic control among patients with type 2 diabetes mellitus

 

Author: Chan, Wai-man Stephanie
Title: Predictors of diabetic control among patients with type 2 diabetes mellitus
Degree: M.Sc.
Year: 2011
Subject: Hong Kong Polytechnic University -- Dissertations
Diabetes -- Treatment
Department: School of Nursing
Pages: xii, 96 leaves ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2412431
URI: http://theses.lib.polyu.edu.hk/handle/200/5967
Abstract: Background: Statistical figures from the Hong Kong Hospital Authority (2008) estimated that there were around 700,000 DM patients in Hong Kong and more than 30% of them were under the long-term caring of the Hong Kong Hospital Authority. In April 2008 to March 2009, among the patients with diabetes who attended the General Out-Patient Clinic of the Hong Kong Hospital Authority, over 52% of them did not achieve an optimal diabetic control. However, it is still not known what factors contributed to an optimal diabetic control among Hong Kong Chinese. Objectives: This study aimed at identifying the characteristics of patients with type 2 diabetes mellitus (DM) who can maintain an optimal diabetic level and examining the predictive factors of optimal diabetic control [Haemoglobin A1c (HbA1c </=7%)] among those patients. Method: A cross-sectional telephone survey was conducted. The interview was guided by a structured questionnaire including items of demographics; health related characteristics, lifestyle behaviors, family support, and diabetic self-management behaviors. Additional information on the level of HbA1c in the last visit and body mass index was retrieved from the Clinical Management System of the Peng Chau Clinic. Results: From May 5 to 20, 2010, a total of 179 patients who had met the inclusion criteria of this study were approached. Totally, 163 of them had completed the interviews (response rate 91.1%). Participants were mostly female (n=91, 55.8%), with an age of 66 or above (n=94%, 57.7%), with a family household income of HK$10,000 or less (n=87, 60.4%). The results showed that patients who had good family support (X² =37.1, df =1, p =0.000), often/ always followed diabetic dietary principles (X² =108.9, df =1, p =0.000), complied with medication regimes (X² =4.7, df =1, p =0.030), and exercised daily (X² =5.7, df =1, p =0.017) were more likely to have an optimal diabetic control. Logistic regression was performed to identify predictive factors of optimal diabetic control. Characteristics of lifestyles, family support, and diabetic self-management behaviors that were found to be statistically and significantly different (p<0.05) between those who had maintained an optimal diabetic control and those who did not, were included in the stepwise logistic regression. Results indicated that (i) having meals on time [Odds Ratio (OR) =0.40; 95% confidence interval (CI); 0.160.99; P=0.048]; and (ii) increasing fluid intake and performing dietary control when hyperglycaemia [OR=0.19; CI = 0.09 0.38; P = 0.000] were the significant predictors of optimal diabetic control identified from the patients of the clinic. Conclusions and implications: The findings indicate that dietary control, family support, medication compliance and daily exercise are associated with a good diabetic control. Among all these factors, strategies in dietary control are the utmost important. Patients' education should therefore focus on food choice recommendations and eating behaviors. Family support and patients' self diabetic management could help patients with type 2 DM to control their blood sugar level and prevent the complications of diabetes.

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